Suicide in Georgia: 2000 State and County Statistics Strategic Plans About 850 Georgians die every year from suicide More Georgians die from suicide than homicide Georgia County Suicide Rates, 1994 - 1998 Rome Gainesville Atlanta Athens County rate significantly higher t rate County rate higher than US rate County rate lower than US rate County rate unreliable Augusta Columbus Macon Dublin Albany Savannah Brunswick Waycross Valdosta AFSP American Foundation for Suicide Prevention, Southeastern Division GEORGIA DEPARTMENT OF HUMAN RESOURCES | DIVISION OF PUBLIC HEALTH Contents page Faces of Suicide .............................................................................................................................................................................. 2 Highlights ........................................................................................................................................................................................... 4 Introduction ...................................................................................................................................................................................... 4 Table 1. 10 Leading Causes of Death by Age Group, Georgia, 1994-1998 Suicide in Georgia ........................................................................................................................................................................ 5 Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Age-Adjusted Suicide Rates, Georgia and the United States, 1984-1998 Age-Adjusted Suicide Rates by Race and Sex, Georgia, 1994-1998 Suicide Rates by Age Group, Georgia, 1994-1998 Average Annual Number of Suicides by Age Group, Georgia, 1994-1998 Suicide Rates for Youth 15-24 Years of Age by Race, Georgia, 1984-1998 Percent of Suicides by Method, Georgia and the United States, 1994-1998 Suicide Statistics by County ................................................................................................................................................. 7 Figure 7. Table 2. Figure 8. Age-adjusted Suicide Rates by County, Georgia, 1994-1998 Age-adjusted Suicide Rates, Number of Suicides, Number and Percent of Firearm Suicides by County, Georgia, 1994-1998 Age-Adjusted Suicide Rates in Urban and Non-Urban Counties, Georgia, 1994-1998 Risk Factors and Protective Actions ........................................................................................................................... 10 Table 3. Risk Factors and Protective Actions for Suicide The Surgeon General's Call to Action to Prevent Suicide, 1999 ................................................................ 10 Summary and Recommendations .................................................................................................................................. 11 Appendix .......................................................................................................................................................................................... 12 Data Sources Methods Definitions For More Information ........................................................................................................................................................... 13 Acknowledgments ..................................................................................................................................................................... 14 Suicide In Georgia 2000 | 1 Faces of Suicide from Lifekeeper Memory Quilts Suicide In Georgia 2000 | 2 www.lifekeeper.org Rank Table 1. Leading Causes of Death, Georgia, 1994 - 1998 Age Groups 0 - 4 (N = 6,325) 5 - 9 (N = 613) 10 - 14 (N = 708) 15 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 + Total (N = 5,275) (N = 8,743) (N = 15,697) (N = 23,676) (N = 35,204) (N = 196,773) (N = 293,014) Suicide In Georgia 2000 | 3 1 Perinatal Unintentional Unintentional Unintentional Unintentional Malignant Malignant Malignant Heart Heart Conditions Injury Injury Injury Injury Neoplasm Neoplasm Neoplasm Disease Disease 2,654 310 341 2,354 2,082 2,556 6,779 11,946 67,458 87,509 2 Congenital Malignant Malignant Homicides HIV Anomalies Neoplasm Neoplasm 980 1,786 1,062 65 65 HIV 2,439 Heart Disease 6,071 Heart Disease 10,439 Malignant Neoplasm 41,155 Malignant Neoplasm 63,570 3 Unintentional Congenital Homicide Suicide Homicide Heart Unintentional Stroke Injury Anomalies 52 648 964 Disease Injury 1,778 571 32 2,439 1,635 Stroke 16,821 Stroke 20,594 Heart Heart Heart Malignant Suicide Unintentional Stroke COPD COPD Unintentional 4 Disease Disease Disease Neoplasm 821 Injury 1,193 1,553 10,404 Injury 168 24 42 226 2,208 14,916 Homicide HIV 5 107 13 Suicide 30 Heart Disease 204 Malignant Neoplasm 716 Suicide 933 HIV Unintentional Pneumonia & COPD 956 Injury Influenza 12,671 1,159 8,892 Pneumonia & Pneumonia & Congenital HIV 6 Influenza Influenza Anomalies 113 107 13 20 Heart Disease 664 Homicide 755 Chronic Liver Disease 711 Diabetes 955 Diabetes 4,351 Pneumonia & Influenza 10,548 Septicemia Homicide Pneumonia & Congenital Stroke Stroke Suicide Chronic Liver Unintentional Diabetes 7 73 10 Influenza Anomalies 158 534 690 Disease Injury 6,242 12 59 699 4,256 Malignant Stroke COPD Pneumonia & Pneumonia & Chronic Liver Diabetes Pneumonia & Septicemia HIV 8 Neoplasm 10 12 Influenza Influenza Disease 532 Influenza 3,237 5,717 62 50 125 416 613 9 Stroke 58 Septicemia 8 Stroke 9 Stroke 33 Diabetes Pneumonia & 95 Influenza COPD 475 Septicemia 410 Nephritis & Nephrosis Suicide 4,242 302 3,049 COPD, 10 HIV Anemia, Anemia Diabetes, Chronic Liver Diabetes Pneumonia & Suicide Alzheimer's Septicemia 39 Benign Tumor 6 Anemia Disease 278 Influenza 400 Disease 4,187 7 each 28 each 69 420 2,874 Highlights From 1994 through 1998, an average of 848 In Georgia, from 1994-1998, nearly three out Georgians per year died from suicide. of four suicides (73%) involved a firearm. Suicide is the ninth most common cause of The suicide rate for Georgia's non-urban death in Georgia. counties is nearly 18% higher than the rate for urban counties. From 1994 through 1998, 18% more Geor- gians died from suicide than homicide. Appropriate clinical care for mental health, substance abuse, and physical health can Suicide rates are five times higher for males reduce the frequency of suicide. than for females in Georgia. Restricted access to highly lethal or common Suicide rates are two times higher for whites than for blacks in Georgia. methods, such as firearms or sedatives, can reduce the frequency of suicide. 15% of suicide deaths in Georgia occur among The Surgeon General's Call to Action to people 15-24 years of age. Prevent Suicide, 1999 provides a framework and 15 recommended actions to prevent The suicide rate among young blacks, 15-24 suicide. years of age, was 40% higher in 1996-1998 than it was in 1984-1986. Introduction Suicide is a leading cause of death in Georgia. From 1994-1998, 4,242 Georgians died of suicide, an average of 848 per year, making it the ninth most common cause of death in the state (Table 1). For younger people suicide ranks even higher as a cause of death. Among those 15-24 years of age, for example, it is the third most common cause of death. Overall, suicide is more common than homicide, causing in recent years nearly 20% more deaths each year. Suicide attempts are also costly. Nationwide, for each suicide death approximately five people are hospitalized and 20 visit emergency departments for injuries related to a suicide attempt. Suicide rates in Georgia differ by sex, race, and age. Rates are five times higher for males than for females and two times higher for whites than for blacks. Suicide rates in Georgia are highest among residents 75 years of age and older. In Georgia, three out of four (73%) suicide deaths involved a firearm. The large number of deaths and the potential preventability of suicide have established it as a public health priority. Governor Barnes and the Georgia Legislature set aside $250,000 to develop a plan to prevent suicide in Georgia. The recently released U.S. Surgeon General's Call to Action to Prevent Suicide provides guidelines to increase the public's awareness of suicide and its risk factors, to enhance clinical services and prevention programs, and to advance the science of suicide prevention. This report, Suicide in Georgia: 2000, provides information about the burden of suicide in Georgia. It describes the sex, race, and age characteristics of those who die from suicide, the methods they most commonly use, and death rates for each county. The report combines deaths during the five year period 1994-1998 to provide more stable estimates. Suicide In Georgia 2000 | 4 Suicide in Georgia Suicide is a leading cause of death in Georgia. From 1994-1998, 4,242 Georgians died of suicide, an average of 848 per year and an age-adjusted death rate of 11.8 per 100,000 population. Suicide was the ninth most common cause of death (Table 1). For younger people it ranked even higher. Among those 15-24 years of age, suicide was the third most common cause of death. Since 1984 suicide rates in Georgia and the United States have been fairly stable (Figure 1). In most years, the Georgia rate exceeded the U.S. rate. Between 1984 and 1991, suicide rates rose slightly, peaking in 1991 at an age-adjusted rate of 13.9 deaths per 100,000 Georgia residents. Since 1991, suicide rates in Georgia have declined an average of 3% per year. From 1994-1998, 18% more Georgians died from suicide than homicide. In recent years both suicide and homicide rates have declined. However, the rate of decline has been smaller for suicide than for homicide. Since 1991, Georgia suicide rates have decreased an average of only 3% per year, but homicide rates have decreased 6% per year. Men have higher suicide rates than women, and whites have higher rates than blacks. From 19941998, the age-adjusted suicide rate for males was five times higher than for females (21.0 per 100,000 persons versus 4.2); and two times higher for whites than for blacks (13.8 per 100,000 persons versus 6.2). In Georgia the risk for dying from suicide was twice as high for white males as for black males and 3.5 times higher for white females than for black females (Figure 2). The death rates for men exceed the rates for women in part because men typically choose more lethal means to commit suicide, such as firearms, when compared to women. Racial differences are more difficult to explain and seem to involve many interacting factors. Figure 1. Age-Adjusted Suicide Rates, Georgia and the United States, 1984-1998 Figure 2. Age-Adjusted Suicide Rates by Race and Sex, Georgia, 1994-1998 Figure 3. Suicide Rates by Age Group, Georgia, 1994-1998 Suicide In Georgia 2000 | 5 Figure 4. Average Annual Number of Suicides by Age Group, Georgia, 1994-1998 Figure 5. Suicide Rates for Youth 15-24 Years of Age by Race, Georgia, 1984-1998 Figure 6. Percent of Suicides by Method, Georgia and the United States, 1994-1998 Suicide rates are highest among older Georgia residents. Persons 75 years of age and older have the highest rate (20.8/100,000 persons) (Figure 3). Suicide rates may be higher among older adults because they are more likely to live alone, to be widowed, and to have a physical illness. Despite the higher risk of suicide for an older person than a younger person (Figure 3), more younger Georgians die from suicide than older adults (Figure 4) because there are more younger Georgians than older. Between 1994 and 1998, 58% of suicide deaths were among persons younger than 45 years of age. Suicide is the third most common cause of death for Georgians 15-24 years of age, exceeded only by unintentional injury and homicide (Table 1). This young age group accounts for 15% of all suicide deaths. Between 1984 and 1995, suicide rates among young blacks (ages 15-24) more than doubled; during the same time period, rates among young whites were stable (Figure 5). The suicide rate among young blacks fell in the most recent time period, 1996-1998, but remained 1.4 times higher than for the period from 1984-1986. Risk factors associated with suicides among youth include hopelessness, depression, family history of suicide, impulsive and aggressive behavior, social isolation, a previous suicide attempt, and ready access to alcohol, illicit drugs, and lethal suicide methods. In Georgia, from 1994-1998 nearly three out of four suicides (73%) involved a firearm (Figure 6). In contrast, for the United States as a whole 58% of suicide deaths involved a firearm. The next most common methods in both Georgia and the United States were poisoning and strangulation. Suicide In Georgia 2000 | 6 Suicide Statistics by County For the period from 1994 through 1998, thirteen Georgia counties (Fannin, Lumpkin, Pickens, Polk, Rome Carroll, Harris, Wilkinson, Twiggs, Bleckley, Bryan, Tattnall, Wayne, and Ware) had Atlanta suicide rates that were signifi- cantly higher (p < .10) than the national rate (Figure 7). Another 57 counties had rates higher than the national rate but the difference was not statistically significant. Columbus Rates were not calculated for 64 Georgia counties because less than 10 residents died of suicide during the five year period. Gainesville Athens Figure 7. Age-Adjusted Suicide Rates by County, 1994 - 1998. Augusta Macon Dublin Savannah Table 2 shows the district or county name (column 1), the ageadjusted suicide rates for the five-year period between 1994 and 1998 (column 2), the number of suicide deaths between 1994 and 1998 (column 3), the number of firearm suicides (column 4), and the percent of suicides which were firearm suicides (column 5). Counties with suicide rates significantly higher than the overall suicide rate for the United States are shown in bold. Caution should be used when comparing county death rates because counties with small populations are more likely to have wide variations in death rates from year to year. Albany Valdosta Waycross Brunswick County rate significantly higher than US rate County rate higher than US rate County rate lower than US rate County rate unreliable Figure 7. Age-Adjusted Suicide Rates in Urban and Non-Urban Counties, Georgia, 1994-1998 Suicide rates in Georgia are significantly higher in non-urban counties compared to urban counties (Figure 8). The suicide rate for Georgia's 117 non-urban counties combined is 18% higher than the rate for Georgia's 42 urban counties (12.9 per 100,000 people versus 10.9).* Suicide In Georgia 2000 | 7 * see definitions, page 12, for a list of urban counties Table 2. Georgia District and County Suicides, 1994 - 1998 Combined. District/County Name AgeAdjusted Suicide Rate1 Georgia District 1-1: Northwest 11.8 12.4 Bartow 12.5 Catoosa 10.1 Chattooga 13.6 Dade 10.6 Floyd 11.5 Gordon 15.2 Haralson 17.7 Paulding 10.8 Polk 19.6 Walker 9.2 District 1-2: Dalton 12.3 Cherokee 7.6 Fannin 23.9 Gilmer 15.1 Murray 14.0 Pickens 20.1 Whitfield 13.2 District 2: Gainesville 12.3 Banks 14.9 Dawson 3.5 Forsyth 11.4 Franklin 17.5 Habersham 15.3 Hall 11.3 Hart 16.2 Lumpkin 22.8 Rabun 14.6 Stephens 8.0 Towns 11.7 Union 8.2 White 13.1 District 3-1: Cobb-Douglas 11.0 Cobb 10.7 Douglas 12.4 District 3-2: Fulton 11.6 Fulton 11.6 District 3-3: Clayton 11.1 Clayton 11.1 District 3-4: East Metro 10.9 Gwinnett 10.8 Newton 9.8 Rockdale 12.9 District 3-5: DeKalb 10.2 DeKalb 10.2 Number Number of Suicide of Deaths Firearm Suicides 4,242 284 3,097 214 Percent of Suicides by Firearm 73 75 41 30 73 25 16 64 16 11 69 8 6 75 49 41 84 29 21 72 21 16 76 33 30 91 34 22 65 28 21 75 175 129 74 49 34 69 21 14 67 13 12 92 21 17 81 18 15 83 53 37 70 232 180 78 9 5 56 1 1 100 37 25 68 16 14 88 24 18 75 65 50 77 17 12 71 19 16 84 11 9 82 10 9 90 5 5 100 7 6 86 11 10 91 320 218 68 272 183 67 48 35 73 411 264 64 411 264 64 111 74 67 111 74 67 296 209 71 230 165 72 25 18 72 41 26 63 297 199 67 297 199 67 District/County Name AgeAdjusted Suicide Rate1 District 4: LaGrange 13.2 Butts 16.4 Carroll 18.3 Coweta 14.8 Fayette 10.6 Heard 14.8 Henry 13.8 Lamar 12.8 Meriwether 8.9 Pike 8.6 Spalding 12.1 Troup 13.4 Upson 10.7 District 5-1: South Central 11.9 Bleckley 25.1 Dodge 10.4 Johnson 13.2 Laurens 12.9 Montgomery 7.4 Pulaski 5.5 Telfair 13.7 Treutlen 3.4 Wheeler 3.5 Wilcox 10.5 District 5-2: North Central 13.7 Baldwin 12.7 Bibb 13.4 Crawford 13.9 Hancock 3.8 Houston 12.0 Jasper 6.8 Jones 16.0 Monroe 16.4 Peach 13.8 Putnam 17.9 Twiggs 23.8 Washington 15.5 Wilkinson 26.4 District 6: Augusta 10.3 Burke 12.8 Columbia 6.0 Emanuel 17.9 Glascock 17.6 Jefferson 13.0 Jenkins 2.4 Lincoln 17.7 Number Number Percent of Suicide of of Deaths Firearm Suicides Suicides by Firearm 352 255 72 14 13 93 71 55 77 52 33 63 40 26 65 7 6 86 58 45 78 9 5 56 10 5 50 5 4 80 34 26 76 38 30 79 14 7 50 74 61 82 14 12 86 9 6 67 5 3 60 27 23 85 3 3 100 2 2 100 8 6 75 1 1 100 1 1 100 4 4 100 300 239 80 26 25 96 102 74 73 7 7 100 2 2 100 60 43 72 3 3 100 16 12 75 15 14 93 15 11 73 15 13 87 11 10 91 15 13 87 13 12 92 206 161 78 13 10 77 24 20 83 18 15 83 2 2 100 11 11 100 1 1 100 7 3 43 Suicide In Georgia 2000 | 8 Table 2. Georgia District and County Suicides, 1994 - 1998 Combined. District/County Name AgeAdjusted Suicide Rate1 McDuffie 7.5 Richmond 10.8 Screven 13.4 Taliaferro 31.3 Warren 12.8 Wilkes 8.0 District 7: West Central 12.1 Chattahoochee 23.4 Clay 22.2 Crisp 9.3 Dooly 21.9 Harris 20.2 Macon 15.7 Marion 6.9 Muscogee 10.7 Quitman 11.0 Randolph 10.3 Schley 4.7 Stewart 26.1 Sumter 11.9 Talbot 14.1 Taylor 10.2 Webster 0.0 District 8-1: Valdosta 13.3 Ben Hill 10.6 Berrien 18.7 Brooks 13.4 Cook 16.3 Echols 22.9 Irwin 16.0 Lanier 0.0 Lowndes 13.5 Tift 12.6 Turner 16.2 District 8-2: Southwest 12.1 Baker 12.3 Calhoun 10.7 Colquitt 14.0 Decatur 11.8 Dougherty 10.3 Early 3.1 Grady 16.7 Lee 15.1 Number Number of Suicide of Deaths Firearm Suicides 8 6 101 75 10 9 3 1 4 4 4 4 200 143 8 5 4 3 9 8 11 7 21 14 10 7 2 2 94 63 2 2 4 2 1 1 7 6 18 15 5 4 4 4 0 0 135 100 9 6 14 11 10 8 11 9 2 2 7 5 0 0 53 38 22 15 7 6 196 161 2 2 3 3 27 25 15 11 47 36 2 2 18 15 15 12 Percent of Suicides by Firearm 75 74 90 33 100 100 72 63 75 89 64 67 70 100 67 100 50 100 86 83 80 100 0 74 67 79 80 82 100 71 0 72 68 86 82 100 100 93 73 77 100 83 80 Bold are statistically significantly higher than the United States rate. District/County Name AgeAdjusted Suicide Rate1 Number Number of Suicide of Deaths Firearm Suicides Miller 13.0 4 4 Mitchell 12.7 12 7 Seminole 5.9 3 2 Terrell 12.8 7 7 Thomas 13.1 27 23 Worth 13.2 14 12 District 9-1: Savannah 12.3 154 109 Chatham 12.1 133 94 Effingham 13.9 21 15 District 9-2: Southeast 13.5 193 148 Appling 6.5 5 4 Atkinson 13.0 4 3 Bacon 16.2 8 7 Brantley 12.3 8 7 Bulloch 8.2 19 15 Candler 17.0 7 6 Charlton 0.0 0 0 Clinch 6.0 2 1 Coffee 13.4 21 17 Evans 17.5 8 6 Jeff Davis 12.6 8 6 Pierce 7.1 5 5 Tattnall 27.3 25 19 Toombs 14.1 17 14 Ware 19.0 34 25 Wayne 18.3 22 13 District 9-3: Coastal 12.5 119 91 Bryan 19.6 20 16 Camden 8.3 16 10 Glynn 13.4 45 36 Liberty 10.8 27 20 Long 7.3 3 3 McIntosh 16.5 8 6 District 10: Athens 12.5 119 91 Barrow 13.2 24 17 Clarke 10.0 46 36 Elbert 13.9 13 11 Greene 7.8 5 5 Jackson 14.5 25 17 Madison 15.0 18 12 Morgan 8.4 6 6 Oconee 8.4 9 9 Oglethorpe 15.1 8 7 Walton 13.7 32 22 1 Age-adjusted to the United States Standard Population 2000 Percent of Suicides by Firearm 100 58 67 100 85 86 71 71 71 77 80 75 88 88 79 86 0 50 81 75 75 100 76 82 74 59 76 80 63 80 74 100 75 76 71 78 85 100 68 67 100 100 88 69 Suicide In Georgia 2000 | 9 Risk Factors and Protective Actions Risk factors are associated with a greater potential for suicide and suicidal behavior. For many of the risk factors for suicide, protective actions can be taken that will reduce risk (Table 3). Table 3. Risk Factors and Protective Actions for Suicide* Risk Factors Protective Actions Mental disorders - particularly mood disorders such as depression and bi-polar disorder Appropriate clinical care for mood disorders Substance abuse Appropriate clincal care for substance abuse Physical illness Appropriate clinical care for physical illness Barriers to appropriate clinical care Improved access and coverage for mental health, substance abuse, and physical health problems Easy access to highly lethal (e.g., firearms) or common methods (e.g., sedatives) of suicide Restricted access to highly lethal or common methods of suicide Family history of suicide or previous suicide attempt Recognition and referral Hopelessness or depression Recognition and referral Financial loss or social isolation Family and community support Cultural or religious beliefs that suicide is a noble resolution Cultural or religious beliefs that discourage suicide *Adapted from The Surgeon General's Call to Action to Prevent Suicide, 1999. The Surgeon General's Call to Action to Prevent Suicide, 1999 The recently released The Surgeon General's Call to Action to Prevent Suicide, 1999 is a framework for action at the local, state, and federal level. The Call to Action includes 15 recommendations for preventing suicide by reducing risk factors and promoting protective actions. The recommendations are grouped under three headings, Awareness, Intervention, and Methodology, or AIM. The three categories and their accompanying recommendations are presented here. Awareness: Appropriately broaden the public's awareness of suicide and its risk factors. Promote public awareness that suicide is a public health problem and that many suicides are preventable. Expand awareness of and enhance resources in communities for suicide prevention programs and mental and substance abuse disorder assessment and treatment. Develop and implement strategies to reduce the stigma associated with mental illness, substance abuse, and suicidal behavior and with seeking help for such problems. Intervention: Enhance services and programs, both population-based and clinical care. Extend collaboration with and among public health and private sectors to complete a National Strategy for Suicide Prevention and a Georgia Strategy for Suicide Prevention. Improve the ability of primary care providers to recognize and treat depression, substance abuse, and other major mental health illnesses associated with suicide risk. Eliminate barriers in public and private insur- Suicide In Georgia 2000 | 10 ance programs for provision of quality mental portrayals of suicide and its associated risk and substance abuse disorder treatments and factors including mental illness and substance create incentives to treat patients with coexist- abuse disorders and approaches to prevention ing mental and substance abuse disorders. and treatment. Institute training for all health, mental health, substance abuse, and human service profession- Methodology: Advance the science of suicide als concerning suicide risk assessment and prevention. recognition, treatment, management, and after- care interventions. Enhance research to understand risk and protec- Develop and implement effective training tive factors related to suicide, their interaction, programs for family members of those at risk and their effects on suicide and suicidal behav- and for natural community helpers (educators, iors. Additionally, increase research on effective coaches, hairdressers, and faith leaders, etc.) on suicide prevention programs, clinical treatments how to recognize, respond to, and refer people for suicidal individuals, and culture-specific showing signs of suicide risk and associated interventions. mental and substance abuse disorders. Develop additional scientific strategies for Develop and implement safe and effective evaluating suicide prevention interventions and programs in educational settings for youth that ensure that evaluation components are included address adolescent distress, provide crisis in all suicide prevention programs. intervention, and incorporate peer support for Establish mechanisms for federal, regional, and seeking help. state interagency public health collaboration Enhance community care resources by increas- toward improving monitoring systems for ing the use of schools and workplaces as access suicide and suicidal behaviors and develop and and referral points for mental and physical promote standard terminology in these systems. health services and substance abuse treatment Encourage the development and evaluation of programs and provide support for persons who new prevention technologies, including firearm survive the suicide of someone close to them. safety measures, to reduce easy access to lethal Promote a public/private collaboration with the means of suicide. media to assure that entertainment and news coverage represent balanced and informed Summary and Recommendations Information in this report documents that suicide is an important public health issue for the residents of Georgia. Suicide causes about 850 deaths every year in Georgia. Suicide is about five times more common among men than women; two times more common among whites than blacks. Rates among young blacks are 1.4 times higher than 15 years ago. Suicide rates are about 20% higher in nonurban than urban areas; and three out of four suicides in Georgia involve a firearm. Suicide rates in Georgia and in the nation can be reduced by a combination of 1) increased awareness of the risk factors for suicide, 2) improved services and programs, 3) restricted access to highly lethal and common methods of suicide, and 4) evaluation of new suicide prevention efforts. Combined public and private efforts will be necessary to achieve these goals. Suicide In Georgia 2000 | 11 Appendix Data Sources Methods Definitions The source for the number and cause of deaths in Georgia was the Georgia Department of Human Resources, Division of Public Health, Vital Records Branch. The source for the Georgia population estimates was the US Bureau of the Census; estimates from December 1998 were used. The source for national suicide death rates was the National Center for Health Statistics, Centers for Disease Control and Prevention. International Classification of Diseases, 9th Revision, codes for suicide are E950-959. Suicide death rates were age-adjusted using the direct method. The United States Standard Population 2000 was used as the standard. Standard errors for age-adjusted rates were calculated as described in: National Center for Health Statistics, CDC, Monthly Vital Statistics Report, volume 45, number 11 (S)2, June 12, 1997, page 77. P < .10 was considered significant. Age-adjusted death rate - A rate calculated in a manner that allows for the comparison of populations with different age structures. Risk factor - A habit, characteristic, or finding on clinical examination that is consistently associated with increased probability of a condition or complication from that condition. Urban - Counties in designated metropolitan statistical areas according to the US Bureau of Census. Urban counties in Georgia are Dougherty and Lee (Albany), Clarke, Madison, and Oconee (Athens), Barrow, Bartow, Carroll, Cherokee, Clayton, Cobb, Coweta, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Henry, Newton, Paulding, Pickens, Rockdale, Spalding, and Walton (Atlanta), Columbia, McDuffie, and Richmond (Augusta), Catoosa, Dade, and Walker (Chattanooga), Chattahoochee, Harris, and Muscogee (Columbus), Bibb, Houston, Jones, Peach, and Twiggs (Macon), and Bryan, Chatham, and Effingham (Savannah). Suicide In Georgia 2000 | 12 For More Information In Georgia and in the United States many individuals and organizations are working toward the goals of the Surgeon General's Report and, ultimately, toward the goal of preventing suicide in Georgia. Some of these organizations are listed below. Interested persons are encouraged to contact these groups for more information. For Help In A Suicide Emergency In Georgia Call 911 Or Your Local 7 Digit Emergency Number. For information about Suicide Survivors Support Groups call 404-256-9797 Agencies Collaborating to Prevent Suicide in Georgia American Foundation for Suicide Prevention, Southeastern Division Phone: 888-333-2377 (Toll free, no local number) Georgia Department of Human Resources, Division of Public Health Phone: 404-679-0500 Georgia Mental Health Consumer Network Phone: 404-687-9487 Georgia Parent Support Network Phone: 404-758-4500 Phone: 800-832-8645 (Toll free) Georgia School Counselors Association Phone: 770-785-9302 The Link Counseling Center Phone: 404-256-9797 National Alliance for the Mentally Ill (NAMI) -Georgia Phone: 770-234-0855 Phone: 800-728-1052 (Toll free) National Mental Health Association of Georgia Phone: 404-527-7175 National Organization for People of Color Against Suicide Georgia Contact Phone: 404-505-7703 National Resource Center for Suicide Prevention and Aftercare Phone: 404-256-9797 Suicide Prevention Advocacy Network (SPAN) Georgia Contact Phone: 404-505-7703 Time for Community Coalition Phone: 404-687-9891 Suicide In Georgia 2000 | 13 National Suicide Prevention Organizations American Association of Suicidology (AAS) 4201 Connecticut Avenue, NW, Suite 408 Washington, DC 20008 Phone: 202-237-2280 E-mail: ssilive16@ixnetcom.com Website: www.suicidology.org National Alliance for The Mentally Ill (NAMI) 2107 Wilson Boulevard, 3rd Floor Arlington, Virginia 22201 Phone: 800-950-6264(Toll free) Website: www.nami.org National Depressive and Manic-Depressive Association (NDMDA) 730 North Franklin Street, Suite 501 Chicago, Illinois 60610-3526 Phone: 800-826-3632 (Toll free) Website: www.ndmda.org National Mental Health Association (NMHA) 1021 Prince Street Alexandria, Virginia 2231-2971 Phone: 800-969-NMHA (Toll free) Website: www.nmha.org National Organization for People of Color Against Suicide P. O. Box 125 San Marcos, Texas 78667 Phone: 830-625-3576 E-mail: db31@swt.ed American Foundation for Suicide Prevention (AFSP) 120 Wall Street, 22nd Floor New York, New York 10005 Phone: 888-333-2377 (Toll free) E-mail: rfabrika@asfp.org Website: www.afsp.org National Center for Injury Prevention and Control (CDC) Division of Violence Prevention Centers for Disease Control and Prevention Mailstop K60, 4770 Buford Highway Atlanta, Georgia 30341-3724 Phone: 770-488-4362 E-mail: dvpinfo@cdc.gov Website: www.cdc.gov National Institute of Mental Health (NIMH) 6001 Executive Boulevard, Room 8184, MSC 9663 Bethesda, Maryland 20892-9663 Phone: 301-443-4513 E-mail: nimhinfo@nih.gov Website: www.nimh.nih.gov SA\VE-Suicide Awareness\Voices of Education 7317 Cahill Road, Suite 207 Edina, Minnesota 55439 Phone: 612-946-7998 E-mail: save@winternet.com Website: www.save.org Suicide Prevention Advocacy Network USA (SPAN USA) 5034 Odins Way Marietta, Georgia 30068 Phone: 888-649-1366 (toll free) E-mail: act@spanusa.org Website: www.spanusa.org Acknowledgments Georgia Department of Human Resources .............................................................................. Audrey W. Horne, Commissioner Division of Public Health ............................................................................. Kathleen E. Toomey, M.D., M.P.H., Director Environmental Health and Injury Prevention Branch .............................................................. Michael R. Smith, Director Epidemiology Branch ............................................................................................. Paul A. Blake, M.D., M.P.H., Director Chronic Disease, Injury, and Environmental Health Epi Section ........................ Kenneth E. Powell, M.D., M.P.H., Chief American Foundation for Suicide Prevention, Southeastern Division Executive Director, National Office ............................................................................................................. Robert Gebbia Suggested Citation: Anderson MA, Powell KE, Davidson SC. Suicide in Georgia: 2000. Georgia Department of Human Resources, Division of Public Health, Epidemiology Section, June 2000. Publication number DPH00.34H Further information on this report may be obtained by contacting: Steve Davidson, Director Office of Injury Prevention, Environmental Health and Injury Prevention Branch Division of Public Health, Georgia Department of Human Resources 2600 Skyland Drive, Upper Level, Suite 10, Atlanta, GA 30319 404-679-0500 Suicide In Georgia 2000 | 14 For Help In A Suicide Emergency In Georgia Call 911 Or Your Local 7 Digit Emergency Number. For information about Suicide Survivors Support Groups call 404-256-9797 Risk Factors and Protective Actions for Suicide* Risk Factors Protective Actions Mental disorders - particularly mood disorders such Appropriate clinical care for mood disorders as depression and bi-polar disorder Substance abuse Appropriate clincal care for substance abuse Physical illness Appropriate clinical care for physical illness Barriers to appropriate clinical care Improved access and coverage for mental health, substance abuse, and physical health problems Easy access to highly lethal (e.g., firearms) or com- Restricted access to highly lethal or common methods mon methods (e.g., sedatives) of suicide of suicide Family history of suicide or previous suicide attempt Recognition and referral Hopelessness or depression Recognition and referral Financial loss or social isolation Family and community support Cultural or religious beliefs that suicide is a noble resolution Cultural or religious beliefs that discourage suicide *Adapted from The Surgeon General's Call to Action to Prevent Suicide, 1999. Suicide In Georgia 2000 | 16